Ultrasonic surgical instrument with axisymmetric clamping

ABSTRACT

A surgical instrument includes an end effector, and a shaft assembly. The end effector includes an ultrasonic blade, a rotating body, and a clamp arm movable between an open and a closed position. The shaft assembly extends along an axis and includes clamp arm clocking assembly and a clamp arm pivot assembly. The clamp arm clocking assembly can drive the rotating body and the clamp arm between a first clocked position and a second clocked position. The clamp arm pivot assembly includes an actuator body defining a track, where the actuator body can actuate to drive the clamp arm between the open position and the closed position while the actuator body is in a rotational position relative to the ultrasonic blade. The track houses a portion of the clamp arm in the first clocked position and the second clocked position while the actuator body is in the rotational position.

BACKGROUND

A variety of surgical instruments include an end effector having a bladeelement that vibrates at ultrasonic frequencies to cut and/or sealtissue (e.g., by denaturing proteins in tissue cells). These instrumentsinclude one or more piezoelectric elements that convert electrical powerinto ultrasonic vibrations, which are communicated along an acousticwaveguide to the blade element. The precision of cutting and coagulationmay be controlled by the operator's technique and adjusting the powerlevel, blade edge angle, tissue traction, and blade pressure. The powerlevel used to drive the blade element may be varied (e.g., in real time)based on sensed parameters such as tissue impedance, tissue temperature,tissue thickness, and/or other factors. Some instruments have a clamparm and clamp pad for grasping tissue with the blade element.

Such surgical instruments may be directly gripped and manipulated by asurgeon or incorporated into a robotically assisted surgery. Duringrobotically assisted surgery, the surgeon typically operates a mastercontroller to remotely control the motion of such surgical instrumentsat a surgical site. The controller may be separated from the patient bya significant distance (e.g., across the operating room, in a differentroom, or in a completely different building than the patient).Alternatively, a controller may be positioned quite near the patient inthe operating room. Regardless, the controller typically includes one ormore hand input devices (such as joysticks, exoskeletol gloves, mastermanipulators, or the like), which are coupled by a servo mechanism tothe surgical instrument. In one example, a servo motor moves amanipulator supporting the surgical instrument based on the surgeon'smanipulation of the hand input devices. During the surgery, the surgeonmay employ, via a robotic surgical system, a variety of surgicalinstruments including an ultrasonic blade, a tissue grasper, a needledriver, an electrosurgical cautery probes, etc. Each of these structuresperforms functions for the surgeon, for example, cutting tissue,coagulating tissue, holding or driving a needle, grasping a bloodvessel, dissecting tissue, or cauterizing tissue.

Examples of ultrasonic surgical instruments include the HARMONIC ACE®Ultrasonic Shears, the HARMONIC WAVE® Ultrasonic Shears, the HARMONICFOCUS® Ultrasonic Shears, and the HARMONIC SYNERGY® Ultrasonic Blades,all by Ethicon Endo-Surgery, Inc. of Cincinnati, Ohio. Further examplesof such devices and related concepts are disclosed in U.S. Pat. No.5,322,055, entitled “Clamp Coagulator/Cutting System for UltrasonicSurgical Instruments,” issued Jun. 21, 1994, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 5,873,873, entitled“Ultrasonic Clamp Coagulator Apparatus Having Improved Clamp Mechanism,”issued Feb. 23, 1999, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 5,980,510, entitled “Ultrasonic ClampCoagulator Apparatus Having Improved Clamp Arm Pivot Mount,” filed Oct.10, 1997, the disclosure of which is incorporated by reference herein;U.S. Pat. No. 6,325,811, entitled “Blades with Functional BalanceAsymmetries for use with Ultrasonic Surgical Instruments,” issued Dec.4, 2001, the disclosure of which is incorporated by reference herein;U.S. Pat. No. 6,773,444, entitled “Blades with Functional BalanceAsymmetries for Use with Ultrasonic Surgical Instruments,” issued Aug.10, 2004, the disclosure of which is incorporated by reference herein;U.S. Pat. No. 8,461,744, entitled “Rotating Transducer Mount forUltrasonic Surgical Instruments,” issued Jun. 11, 2013, the disclosureof which is incorporated by reference herein; U.S. Pat. No. 8,591,536,entitled “Ultrasonic Surgical Instrument Blades,” issued Nov. 26, 2013,the disclosure of which is incorporated by reference herein; and U.S.Pat. No. 8,623,027, entitled “Ergonomic Surgical Instruments,” issuedJan. 7, 2014, the disclosure of which is incorporated by referenceherein; and U.S. Pat. No. 8,911,460, entitled “Ultrasonic SurgicalInstruments,” issued Dec. 16, 2014, the disclosure of which isincorporated by reference herein; and U.S. Pat. No. 9,023,071, entitled“Ultrasonic Device for Fingertip Control,” issued May 5, 2015, thedisclosure of which is incorporated by reference herein.

Still further examples of ultrasonic surgical instruments are disclosedin U.S. Pub. No. 2006/0079874, entitled “Tissue Pad for Use with anUltrasonic Surgical Instrument,” published Apr. 13, 2006, now abandoned,the disclosure of which is incorporated by reference herein; U.S. Pub.No. 2007/0191713, entitled “Ultrasonic Device for Cutting andCoagulating,” published Aug. 16, 2007, now abandoned, the disclosure ofwhich is incorporated by reference herein; U.S. Pub. No. 2007/0282333,entitled “Ultrasonic Waveguide and Blade,” published Dec. 6, 2007, nowabandoned, the disclosure of which is incorporated by reference herein;U.S. Pub. No. 2008/0200940, entitled “Ultrasonic Device for Cutting andCoagulating,” published Aug. 21, 2008, now abandoned, the disclosure ofwhich is incorporated by reference herein; and U.S. Pat. No. 9,023,071,entitled “Ultrasonic Device for Fingertip Control,” issued May 5, 2015,the disclosure of which is incorporated by reference herein.

Some ultrasonic surgical instruments may include a cordless transducersuch as that disclosed in U.S. Pat. No. 9,381,058, entitled “RechargeSystem for Medical Devices,” issued Jul. 5, 2016, the disclosure ofwhich is incorporated by reference herein; U.S. Pub. No. 2012/0116265,entitled “Surgical Instrument with Charging Devices,” published May 10,2012, now abandoned, the disclosure of which is incorporated byreference herein; and/or U.S. Pat. App. No. 61/410,603, filed Nov. 5,2010, entitled “Energy-Based Surgical Instruments,” the disclosure ofwhich is incorporated by reference herein.

Additionally, some ultrasonic surgical instruments may include anarticulating shaft section. Examples of such ultrasonic surgicalinstruments are disclosed in U.S. Pat. No. 9,393,037, issued Jul. 19,2016, entitled “Surgical Instruments with Articulating Shafts,” thedisclosure of which is incorporated by reference herein; U.S. Pat. No.9,095,367, issued Aug. 4, 2015, entitled “Flexible HarmonicWaveguides/Blades for Surgical Instruments,” the disclosure of which isincorporated by reference herein; U.S. Pat. No. 10,226,274, issued Mar.12, 2019, entitled “Ultrasonic Surgical Instrument with ArticulationJoint Having Plurality of Locking Positions,” the disclosure of which isincorporated by reference herein; U.S. Pat. No. 10,034,683, entitled“Ultrasonic Surgical Instrument with Rigidizing Articulation DriveMembers,” issued Jul. 31, 2018, the disclosure of which is incorporatedby reference herein; U.S. Pat. Pub. No. 2016/0302818, published Oct. 10,2016, now abandoned, entitled “Ultrasonic Surgical Instrument withMovable Rigidizing Member,” the disclosure of which is incorporated byreference herein; U.S. Pat. Pub. No. 2016/0302819, published Oct. 20,2016, now abandoned, entitled “Ultrasonic Surgical Instrument withArticulating End Effector having a Curved Blade,” the disclosure ofwhich is incorporated by reference herein; U.S. Pat. No. 10,342,567,issued Jul. 9, 2019, entitled “Ultrasonic Surgical Instrument withOpposing Thread Drive for End Effector Articulation,” the disclosure ofwhich is incorporated by reference herein; U.S. Pat. Pub. No.2015/0320438, published Nov. 12, 2015, issued as U.S. Pat. No.10,667,835 on Jun. 2, 2020, entitled “Ultrasonic Surgical Instrumentwith End Effector Having Restricted Articulation,” the disclosure ofwhich is incorporated by reference herein; U.S. Pat. Pub. No.2017/0281217, published Oct. 5, 2017, issued as U.S. Pat. No. 10,492,819on Dec. 3, 2019, entitled “Surgical Instrument with Dual ModeArticulation Drive,” the disclosure of which is incorporated byreference herein; U.S. Pat. Pub. No. 2017/0281218, published Oct. 5,2017, entitled “Surgical Instrument with Motorized Articulation Drive inShaft Rotation Knob,” issued as U.S. Pat. No. 10,507,034 on Dec. 17,2019, the disclosure of which is incorporated by reference herein; U.S.Pat. Pub. No. 2017/0281219, published Oct. 5, 2017, entitled “SurgicalInstrument with Locking Articulation Drive Wheel,” issued as U.S. Pat.No. 10,743,850 on Aug. 18, 2020, the disclosure of which is incorporatedby reference herein; U.S. Pat. Pub. No. 2017/0281220, published Oct. 5,2017, issued as U.S. Pat. No. 10,575,836 on Mar. 3, 2020, entitled“Surgical Instrument with Selectively Locked Articulation Assembly,” thedisclosure of which is incorporated by reference herein; and U.S. Pat.Pub. No. 2017/0281221, published Oct. 5, 2017, issued as U.S. Pat. No.10,405,876 on Sep. 10, 2019, entitled “Articulation Joint for SurgicalInstrument,” the disclosure of which is incorporated by referenceherein.

Some instruments are operable to seal tissue by applying radiofrequency(RF) electrosurgical energy to the tissue. An example of a surgicalinstrument that is operable to seal tissue by applying RF energy to thetissue is the ENSEAL® Tissue Sealing Device by Ethicon Endo-Surgery,Inc., of Cincinnati, Ohio. Further examples of such devices and relatedconcepts are disclosed in U.S. Pat. No. 6,500,176 entitled“Electrosurgical Systems and Techniques for Sealing Tissue,” issued Dec.31, 2002, the disclosure of which is incorporated by reference herein;U.S. Pat. No. 7,112,201 entitled “Electrosurgical Instrument and Methodof Use,” issued Sep. 26, 2006, the disclosure of which is incorporatedby reference herein; U.S. Pat. No. 7,125,409, entitled “ElectrosurgicalWorking End for Controlled Energy Delivery,” issued Oct. 24, 2006, thedisclosure of which is incorporated by reference herein; U.S. Pat. No.7,169,146 entitled “Electrosurgical Probe and Method of Use,” issuedJan. 30, 2007, the disclosure of which is incorporated by referenceherein; U.S. Pat. No. 7,186,253, entitled “Electrosurgical Jaw Structurefor Controlled Energy Delivery,” issued Mar. 6, 2007, the disclosure ofwhich is incorporated by reference herein; U.S. Pat. No. 7,189,233,entitled “Electrosurgical Instrument,” issued Mar. 13, 2007, thedisclosure of which is incorporated by reference herein; U.S. Pat. No.7,220,951, entitled “Surgical Sealing Surfaces and Methods of Use,”issued May 22, 2007, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 7,309,849, entitled “PolymerCompositions Exhibiting a PTC Property and Methods of Fabrication,”issued Dec. 18, 2007, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 7,311,709, entitled “ElectrosurgicalInstrument and Method of Use,” issued Dec. 25, 2007, the disclosure ofwhich is incorporated by reference herein; U.S. Pat. No. 7,354,440,entitled “Electrosurgical Instrument and Method of Use,” issued Apr. 8,2008, the disclosure of which is incorporated by reference herein; U.S.Pat. No. 7,381,209, entitled “Electrosurgical Instrument,” issued Jun.3, 2008, the disclosure of which is incorporated by reference herein.

Some instruments are capable of applying both ultrasonic energy and RFelectrosurgical energy to tissue. Examples of such instruments aredescribed in U.S. Pat. No. 9,949,785, entitled “Ultrasonic SurgicalInstrument with Electrosurgical Feature,” issued Apr. 24, 2018, thedisclosure of which is incorporated by reference herein; and U.S. Pat.No. 8,663,220, entitled “Ultrasonic Surgical Instruments,” issued Mar.4, 2014, the disclosure of which is incorporated by reference herein.

While several surgical instruments and systems have been made and used,it is believed that no one prior to the inventors has made or used theinvention described in the appended claims.

BRIEF DESCRIPTION OF THE DRAWINGS

While the specification concludes with claims which particularly pointout and distinctly claim this technology, it is believed this technologywill be better understood from the following description of certainexamples taken in conjunction with the accompanying drawings, in whichlike reference numerals identify the same elements and in which:

FIG. 1 depicts a front perspective view of an ultrasonic surgicalinstrument having an end effector, a shaft assembly, and a base assemblyconfigured to connect to a robotic driven interface;

FIG. 2 depicts a rear perspective view of the ultrasonic surgicalinstrument of FIG. 1;

FIG. 3A depicts an enlarged perspective view of the ultrasonic surgicalinstrument of FIG. 1 with the end effector in a closed position and theshaft assembly in a straight configuration;

FIG. 3B depicts the enlarged perspective view of the ultrasonic surgicalinstrument similar to FIG. 3A, but showing the end effector in an openposition;

FIG. 4A depicts an enlarged perspective view of the ultrasonic surgicalinstrument of FIG. 1 with the end effector in a closed position and theshaft assembly in a first articulated configuration;

FIG. 4B depicts the enlarged perspective view of the ultrasonic surgicalinstrument similar to FIG. 4A, but with the shaft assembly in a secondarticulated configuration;

FIG. 5 depicts an enlarged perspective view of the ultrasonic surgicalinstrument of FIG. 1 with the base assembly having various componentsremoved for greater clarity of an interior space of the base assembly;

FIG. 6 depicts an enlarged front view of the ultrasonic surgicalinstrument of FIG. 1 with the base assembly having various componentsremoved for greater clarity of the interior space of the base assembly;

FIG. 7 depicts a sectional perspective view of an alternative endeffector and alternative distal shaft portion that may be readilyincorporated into the ultrasonic surgical instrument of FIG. 1;

FIG. 8 depicts a partially exploded perspective view of the end effectorand distal shaft portion of FIG. 7, showing a clamp arm closure assemblyand a clamp arm clocking assembly;

FIG. 9 depicts an exploded perspective view of the end effector anddistal shaft portion of FIG. 7;

FIG. 10 depicts a perspective view of a translating body of the clamparm closure assembly of FIG. 8;

FIG. 11 depicts a cross-sectional view of the translating body of FIG.10, taken along section line 11-11 of FIG. 10;

FIG. 12 depicts an elevational side view of a rack of the clamp armclocking assembly of FIG. 8;

FIG. 13 depicts a perspective view of a compound gear of the clamp armclocking assembly of FIG. 8;

FIG. 14 depicts an elevational side view of the compound gear of FIG.13;

FIG. 15 depicts a perspective view of a rotating body of the endeffector of FIG. 7;

FIG. 16 depicts a sectional perspective view of the rotating body ofFIG. 15, taken along section line 16-16 of FIG. 15;

FIG. 17A depicts a perspective view of the end effector and distal shaftportion of FIG. 7, with certain portions omitted for clarity; where aclamp arm of the end effector of FIG. 7 is in an open position in afirst clocked position;

FIG. 17B depicts a perspective view of the end effector and distal shaftportion of FIG. 7, with certain portions omitted for clarity where theclamp arm of FIG. 17A is in the open position in a second clockedposition; and

FIG. 17C depicts a perspective view of the end effector and distal shaftportion of FIG. 7, with certain portions omitted for clarity where theclamp arm of FIG. 17A is in a closed position in the second clockedposition;

The drawings are not intended to be limiting in any way, and it iscontemplated that various embodiments of the technology may be carriedout in a variety of other ways, including those not necessarily depictedin the drawings. The accompanying drawings incorporated in and forming apart of the specification illustrate several aspects of the presenttechnology, and together with the description serve to explain theprinciples of the technology; it being understood, however, that thistechnology is not limited to the precise arrangements shown.

DETAILED DESCRIPTION

The following description of certain examples of the technology shouldnot be used to limit its scope. Other examples, features, aspects,embodiments, and advantages of the technology will become apparent tothose skilled in the art from the following description, which is by wayof illustration, one of the best modes contemplated for carrying out thetechnology. As will be realized, the technology described herein iscapable of other different and obvious aspects, all without departingfrom the technology. Accordingly, the drawings and descriptions shouldbe regarded as illustrative in nature and not restrictive.

It is further understood that any one or more of the teachings,expressions, embodiments, examples, etc. described herein may becombined with any one or more of the other teachings, expressions,embodiments, examples, etc. that are described herein. Thefollowing-described teachings, expressions, embodiments, examples, etc.should therefore not be viewed in isolation relative to each other.Various suitable ways in which the teachings herein may be combined willbe readily apparent to those of ordinary skill in the art in view of theteachings herein. Such modifications and variations are intended to beincluded within the scope of the claims.

For clarity of disclosure, the terms “proximal” and “distal” are definedherein relative to a human or robotic operator of the surgicalinstrument. The term “proximal” refers the position of an element closerto the human or robotic operator of the surgical instrument and furtheraway from the surgical end effector of the surgical instrument. The term“distal” refers to the position of an element closer to the surgical endeffector of the surgical instrument and further away from the human orrobotic operator of the surgical instrument. It will be furtherappreciated that, for convenience and clarity, spatial terms such as“front,” “rear,” “clockwise,” “counterclockwise,” “longitudinal,” and“transverse” also are used herein for reference to relative positionsand directions. Such terms are used below with reference to views asillustrated for clarity and are not intended to limit the inventiondescribed herein.

I. Exemplary Surgical Instrument

FIG. 1 shows an exemplary surgical instrument, such as an ultrasonicsurgical instrument (10). At least part of ultrasonic surgicalinstrument (10) may be constructed and operable in accordance with atleast some of the teachings of any of the various patents, patentapplication publications, and patent applications that are cited herein.As described therein and as will be described in greater detail below,ultrasonic surgical instrument (10) is operable to cut tissue and sealor weld tissue (e.g., a blood vessel, etc.) substantiallysimultaneously. While the present example incorporates variousultrasonic features as ultrasonic surgical instrument (10), theinvention is not intended to be unnecessarily limited to the ultrasonicfeatures described herein.

Ultrasonic surgical instrument (10) of the present example comprises abody assembly, such as a base assembly (12), a shaft assembly (14), andan end effector (16). Base assembly (12) includes a housing (18), abutton (22), and a pair of latch clasps (24). Button (22) is operativelyconnected to an electrical base power controller (not shown) andconfigured to selectively power ultrasonic surgical instrument (10) foruse. In addition, housing (18) of the present example includes a fronthousing cover (26) and a rear housing cover (28) removably securedtogether via latch clasps (24). More particularly, latch clasps (24)removably secure front housing cover (26) to rear housing cover (28)such that front housing cover (26) may be removed for accessing aninterior space (30) (see FIG. 5) within base assembly (12). Shaftassembly (14) distally extends from base assembly (12) to end effector(16) to thereby communicate mechanical and/or electrical forcestherebetween for use as will be discussed below in greater detail. Asshown in the present example, base assembly (12) is configured tooperatively connect to a robotic drive (not shown) for driving variousfeatures of shaft assembly (14) and/or end effector (16). However, inanother example, body assembly may alternatively include a handleassembly (not shown), which may include a pistol grip (not shown) in oneexample, configured to be directly gripped and manipulated by thesurgeon for driving various features of shaft assembly (14) and/or endeffector (16). The invention is thus not intended to be unnecessarilylimited to use with base assembly (12) and the robotic drive (notshown).

To this end, with respect to FIG. 2, base assembly (12) includes arobotic driven interface (32) extending through a base plate (34) ofrear housing cover (28) and configured to mechanically couple with therobotic drive (not shown). Robotic driven interface (32) of the presentexample includes a plurality of instrument actuators (36 a, 36 b, 36 c,36 d, 36 e, 36 f) having a plurality of input bodies (38 a, 38 b, 38 c,38 d, 38 e, 38 f), respectively. Each input body (38 a, 38 b, 38 c, 38d, 38 e, 38 f), which may also be referred to herein as a “puck,” isconfigured to removably connect with the robotic drive (not shown) and,in the present example, is generally cylindrical and rotatable about anaxis. Input bodies (38 a, 38 b, 38 c, 38 d, 38 e, 38 f) have a pluralityof slots (40) configured to receive portions of the robotic drive (notshown) for gripping and rotatably driving input bodies (38 a, 38 b, 38c, 38 d, 38 e, 38 f) in order to direct operation of shaft assembly (14)and/or end effector (16) as will be discussed below in greater detail.Base assembly (12) also receives an electrical plug (42) operativelyconnected to an electrical power source (not shown) to provideelectrical power to base assembly (12) for operation as desired, such aspowering electrical base power controller (not shown) and directingelectrical energy to various features of shaft assembly (14) or endeffector (16) associated with cutting, sealing, or welding tissue.

A. Exemplary End Effector and Acoustic Drivetrain

As best seen in FIGS. 3A-3B, end effector (16) of the present exampleincludes a clamp arm (44) and an ultrasonic blade (46). Clamp arm (44)has a clamp pad (48) secured to an underside of clamp arm (44), facingblade (46). In one example, clamp pad (48) may comprisepolytetrafluoroethylene (PTFE) and/or any other suitable material(s).Clamp arm (44) is pivotally secured to a distally projecting tongue (50)of shaft assembly (14). Clamp arm (44) is operable to selectively pivottoward and away from blade (46) to selectively clamp tissue betweenclamp arm (44) and blade (46). A pair of arms (51) extend transverselyfrom clamp arm (44) and are pivotally secured to another portion ofshaft assembly (14) configured to longitudinally slide to pivot clamparm (44) as indicated by an arrow (52) between a closed position shownin FIG. 3A and an open position shown in FIG. 3B.

In addition to pivoting relative to blade (46), clamp arm (44) of thepresent example is further configured to rotate about blade (46)relative to blade (46) and also relative to shaft assembly (14) asindicated by an arrow (53). In one example, clamp arm (44) rotates inthe clockwise or counterclockwise directions completely around blade(46) and may be selectively fixed in any angular position relative toblade (46) for directing clamp arm (44) from the open position to theclosed position for clamping tissue. In another example, clamp arm (44)may have rotational stops (not shown) configured to limit rotationalmovement of clamp arm (44) relative to blade (46) in one or morepredetermined positions.

Blade (46) of the present example is operable to vibrate at ultrasonicfrequencies in order to effectively cut through and seal tissue,particularly when the tissue is being compressed between clamp pad (48)and blade (46). Blade (46) is positioned at a distal end of an acousticdrivetrain. This acoustic drivetrain includes a transducer assembly (54)(see FIG. 5) and an acoustic waveguide (56), which includes a flexibleportion (58) discussed below in greater detail. It should be understoodthat waveguide (56) may be configured to amplify mechanical vibrationstransmitted through waveguide (56). Furthermore, waveguide (56) mayinclude features operable to control the gain of the longitudinalvibrations along waveguide (56) and/or features to tune waveguide (56)to the resonant frequency of the system. Various suitable ways in whichwaveguide (56) may be mechanically and acoustically coupled withtransducer assembly (54) (see FIG. 5) will be apparent to those ofordinary skill in the art in view of the teachings herein.

Those of ordinary skill in the art will understand that, as a matter ofphysics, a distal end of blade (46) is located at a positioncorresponding to an anti-node associated with resonant ultrasonicvibrations communicated through flexible portion (58) of waveguide (56).When transducer assembly (54) (see FIG. 5) is energized, the distal endof blade (46) is configured to move longitudinally in the range of, forexample, approximately 10 to 500 microns peak-to-peak, and in someinstances in the range of about 20 to about 200 microns at apredetermined vibratory frequency f_(o) of, for example, 55.5 kHz. Whentransducer assembly (54) (see FIG. 5) of the present example isactivated, these mechanical oscillations are transmitted throughwaveguide (56) to reach blade (46), thereby providing oscillation ofblade (46) at the resonant ultrasonic frequency. Thus, when tissue issecured between blade (46) and clamp pad (48), the ultrasonicoscillation of blade (46) may simultaneously sever the tissue anddenature the proteins in adjacent tissue cells, thereby providing acoagulative effect with relatively little thermal spread. In someversions, end effector (16) is operable to apply radiofrequency (RF)electrosurgical energy to tissue in addition to applying ultrasonicenergy to tissue. In any case, other suitable configurations for anacoustic transmission assembly and transducer assembly (54) will beapparent to one of ordinary skill in the art in view of the teachingsherein. Similarly, other suitable configurations for end effector (16)will be apparent to those of ordinary skill in the art in view of theteachings herein.

B. Exemplary Shaft Assembly and Articulation Section

As shown in FIGS. 3A-3B, shaft assembly (14) includes a proximal shaftportion (60) extending along a longitudinal axis (61), a distal shaftportion (62) distally projecting relative to the proximal shaft portion(60), and an articulation section (64) extending between proximal anddistal shaft portions (60, 62). Shaft assembly (14) is configured torotate about longitudinal axis (61) as indicated by an arrow (66). Inone example, shaft assembly (14) rotates in the clockwise orcounterclockwise directions completely around longitudinal axis (61) andmay be selectively fixed in any rotational position about longitudinalaxis (61) for positioning articulation section (64) and/or end effector(16) about longitudinal axis (61). While end effector (16) generallyrotates with shaft assembly (14) as indicated by arrow (66), endeffector (16) may be simultaneously and independently rotated asindicated by arrow (53) relative to shaft assembly (14) during use forrepositioning portions of shaft assembly (14) and/or end effector (16)as desired.

Articulation section (64) is configured to selectively position endeffector (16) at various lateral deflection angles relative tolongitudinal axis (61) defined by proximal shaft portion (60).Articulation section (64) may take a variety of forms. In the presentexample, articulation section (64) includes a proximal link (68), adistal link (70), and a plurality of intermediate links (72) connectedin series between proximal and distal links (68, 70). Articulationsection (64) further includes a pair of articulation bands (74)extending along a pair of respective channels (76) collectively definedthrough links (68, 70, 72). Links (68, 70, 72) are generally configuredto pivot relative to each other upon actuation of articulation bands(74) to thereby bend articulation section (64) with flexible portion(58) of waveguide (56) therein to achieve an articulated state. By wayof example only, articulation section (64) may alternatively oradditionally be configured in accordance with one or more teachings ofU.S. Pat. No. 9,402,682, entitled “Articulation Joint Features forArticulating Surgical Device,” issued Aug. 2, 2016, the disclosure ofwhich is incorporated by reference herein. As another merelyillustrative example, articulation section (64) may alternatively oradditionally be configured in accordance with one or more teachings ofU.S. Pat. No. 9,393,037, issued Jul. 19, 2016, entitled “SurgicalInstruments with Articulating Shafts,” the disclosure of which isincorporated by reference herein and U.S. Pat. No. 9,095,367, issuedAug. 4, 2015, entitled “Flexible Harmonic Waveguides/Blades for SurgicalInstruments,” the disclosure of which is incorporated by referenceherein. In addition to or in lieu of the foregoing, articulation section(64) and/or may be constructed and/or operable in accordance with atleast some of the teachings of U.S. Pat. No. 10,034,683, entitled“Ultrasonic Surgical Instrument with Rigidizing Articulation DriveMembers,” issued on Jul. 31, 2018. Alternatively, articulation section(64) may be constructed and/or operable in any other suitable fashion.

Links (68, 70, 72) shown in FIGS. 3B-4B pivotally interlock to securedistal shaft portion (62) relative to proximal shaft portion (60) whileallowing for deflection of distal shaft portion (62) relative tolongitudinal axis (61). In the present example, proximal link (68) isrigidly connected to proximal shaft portion (60) and has a pair ofarcuate grooves (78) opposed from each other. Intermediate links (72)respectively have a pair of arcuate tongues (80) proximally extendingtherefrom and a pair of arcuate grooves (78) positioned distallyopposite from respective tongues (80). Each intermediate link (72) hastongues (80) pivotally received within adjacent arcuate grooves (78) ofanother intermediate link (72) or proximal link (68) as applicable.Distal link (70) is rigidly connected to distal shaft portion (62) andhas another pair of arcuate tongues (80) opposed from each other andpivotally received within adjacent arcuate grooves (78) of intermediatelink (72). Tongues (80) and grooves (78) connect together to form theseries of interlocked links (68, 70, 72).

Distal link (70) further includes a pair of opposing notches (82) with apin (84) therein configured to receive distal end portions of respectivearticulation bands (74). More particularly, pins (84) extend through ahole in each respective articulation bands (74) while distal endportions of respective articulation bands (74) are coupled withinnotches (82). Slots (86) in each of intermediate and proximal links (72,68) longitudinally align with each other and notches (82) tocollectively define channels (76) configured to receive articulationbands (74) while allowing articulation bands (74) to slide relative tolinks (68, 70, 72). To this end, when articulation bands (74) translatelongitudinally in an opposing fashion, this will cause articulationsection (64) to bend, thereby laterally deflecting end effector (16)away from the longitudinal axis (61) of proximal shaft portion (60) froma straight configuration as shown in FIG. 3B to a first articulatedconfiguration as shown in FIG. 4A and indicated by an arrow (88) or asecond articulated configuration as shown in FIG. 4B and indicated by anarrow (90). In particular, end effector (16) will be articulated towardthe articulation band (74) that is being pulled proximally. During sucharticulation, the other articulation band (74) may be pulled distally.Alternatively, the other articulation band (74) may be driven distallyby an articulation control. Furthermore, flexible acoustic waveguide(56) is configured to effectively communicate ultrasonic vibrations fromwaveguide (56) to blade (46) even when articulation section (64) is inan articulated configuration as shown in FIGS. 4A-4B.

C. Exemplary Base Assembly with Instrument Actuators for RoboticInterface

FIG. 5 shows interior space (30) of base assembly (12) with instrumentactuators (36 a, 36 b, 36 c, 36 d, 36 e, 36 f) in greater detail.Generally, instrument actuators (36 a, 36 b, 36 c, 36 d, 36 e, 36 f) areengaged with shaft assembly (14) and configured to direct movement ofend effector (16) and/or shaft assembly (14), such as movement indicatedabove in one example by arrows (52, 53, 66, 88, 90) (see FIGS. 3A-4B).Shaft assembly (14) is received within base assembly (12) and supportedby bearings (92) therein to operatively connect each respectiveinstrument actuator (36 a, 36 b, 36 c, 36 d, 36 e, 36 f) to shaftassembly (14) as well as operatively connect acoustic waveguide (56)(see FIG. 3A) to transducer assembly (54) and a generator (not shown) ofthe acoustic drivetrain. More particularly, transducer assembly (54) iscoupled with generator (not shown) such that transducer assembly (54)receives electrical power from generator (not shown). Piezoelectricelements (not shown) in transducer assembly (54) convert that electricalpower into ultrasonic vibrations. Generator (not shown) may be coupledto the electrical power source (not shown) via electrical plug (42) (seeFIG. 1) and a control module (not shown) that are configured to providea power profile to transducer assembly (54) that is particularly suitedfor the generation of ultrasonic vibrations through transducer assembly(54). By way of example only, generator (not shown) may comprise a GEN04or GEN11 sold by Ethicon Endo-Surgery, Inc. of Cincinnati, Ohio. Inaddition or in the alternative, generator (not shown) may be constructedin accordance with at least some of the teachings of U.S. Pub. No.2011/0087212, entitled “Surgical Generator for Ultrasonic andElectrosurgical Devices,” published Apr. 14, 2011, issued as U.S. Pat.No. 8,986,302 on Mar. 24, 2015, the disclosure of which is incorporatedby reference herein. Still other suitable forms that generator (notshown) may take, as well as various features and operabilities thatgenerator (not shown) may provide, will be apparent to those of ordinaryskill in the art in view of the teachings herein.

The present example of base assembly (12) shown in FIGS. 5-6 includessix instrument actuators (36 a, 36 b, 36 c, 36 d, 36 e, 36 f), althoughit will be appreciated that any such number of such instrument actuators(36 a, 36 b, 36 c, 36 d, 36 e, 36 f) configured to direct movement ofshaft assembly (14) and/or end effector (16) may be similarly used. Asshown with respect to operation of ultrasonic surgical instrument (10),instrument actuator (36 a) is more particularly a roll system actuator(36 a) configured to rotate shaft assembly (14) about longitudinal axis(61). In contrast, instrument actuators (36 b, 36 c, 36 d, 36 e, 36 f)are linear system actuators (36 b, 36 c, 36 d, 36 e, 36 f) configured totranslationally drive movement of portions of end effector (16) and/orshaft assembly (14) while simultaneously allowing for rotation of shaftassembly (14) via roll system actuator (36 a).

Roll system actuator (36 a) in one example includes a drive spool (96)rigidly connected to puck (38 a) (see FIG. 2) and a driven spool (98)rigidly connected to proximal shaft portion (60) within housing (18).Drive spool (96) is mounted to rotate with puck (38 a) (see FIG. 2)about a common puck axis, whereas driven spool (98) is mounted to rotatewith proximal shaft portion (60) about the longitudinal axis (61). Acable (100) wraps around each of the drive and driven spools (96, 98),accommodating the differing orientation of the puck axis andlongitudinal axis (61), such that rotating drive spool (96) via puck (38a) (see FIG. 2) urges rotation of driven spool (98). In turn, shaftassembly (14), including proximal and distal shaft portions (60, 62)rotates about longitudinal axis (61) as indicated by arrow (66) (seeFIG. 3A), such as by robotically driven actuation of puck (38 a) (seeFIG. 2).

Linear system actuators (36 b, 36 c, 36 d, 36 e, 36 f) of the presentexample include a gear-rack mechanism (102) having a rotatable drivegear (104), a translatable rack gear (106), and an idler gear (108)connected therebetween. Drive gears (104) are respectively connected toand rigidly project from pucks (38 b, 38 c, 38 d, 38 e, 38 f) (see FIG.2), whereas each rack gear (106) is connected to another portion ofproximal shaft portion (60) directing movement of shaft assembly (14)and/or end effector (16) as discussed above. Each rack gear (106) iscylindrical and rigidly connected relative to proximal shaft portion(60) to rotate therewith. Rack gear (106) is thereby configured torotate with shaft assembly (14) while remaining meshed with idler gear(108). Rotating respective pucks (38 b, 38 c, 38 d, 38 e, 38 f) (seeFIG. 2) thus respectively rotates drive gears (104) and idler gears(108) to translate rack gears (106) as desired.

In the present example, with respect to FIGS. 2-4B and FIG. 6, linearsystem actuator (36 b) has puck (38 b) operatively connected to clamparm (44) to direct movement of clamp arm (44) between the open andclosed positions according to arrow (52). Linear systems (36 c, 36 d)have respective pucks (38 c, 38 d) operatively connected to clamp arm(44) to direct movement of clamp arm (44) around blade (46) in both theclockwise and counterclockwise directions according to arrow (53). Inaddition, linear system actuators (36 e, 36 f) have respective pucks (38e, 38 f) operatively connected to articulation bands (74) to directmovement of articulation section (64) according to arrows (88, 90) fordeflecting end effector (16) relative to longitudinal axis (61). Ofcourse, in other examples, instrument actuators (36 a, 36 b, 36 c, 36 d,36 e, 36 f) may be alternatively configured with more or less actuators(36 a, 36 b, 36 c, 36 d, 36 e, 36 f) and/or more or less movement asdesired. The invention is thus not intended to be unnecessarily limitedto instrument actuators (36 a, 36 b, 36 c, 36 d, 36 e, 36 f) orparticular movements of shaft assembly (14) and/or end effector (16) asdescribed in the present example.

II. Exemplary End Effector with Axisymmetric Clamping

As mentioned above, clamp arm (44) is pivotally secured to a portion ofshaft assembly (14) configured to longitudinally slide in order to pivotclamp arm (44), as indicated by arrow (52), between a closed positionand an open position in order to engage tissue. As also mentioned above,clamp arm (44) is configured to rotate in the clockwise orcounterclockwise directions completely around blade (46), as indicatedby arrow (53) (i.e., clocking clamp arm (44)) into various clockedpositions relative to blade (46).

In some instance, it may be desirable to have both features that pivotand clock clamp arm (44) driven by respectively separate linear systemactuators (36 b, 36 c, 36 d, 36 e, 36 f). However, it may be difficultor overly complicated to have the portion of shaft assembly (14) thatpivots clamp arm (44) also rotate with clamp arm (44) into the variousclocked positions. Therefore, it may be desirable to have the portion ofshaft assembly (14) that pivots clamp arm (44) translate in order topivot clamp arm (44) at any clocked position, without having to rotatewith clamp arm (44) to the various clocked positions in order tomaintain operable engagement with clamp arm (44). This may simplify thedesign of end effector (16) and distal shaft portion (62), as well asprovide for a higher degree of precision for clamping of clamp arm (44).

FIGS. 7-9 show an alternative ultrasonic instrument (10′) with analternative end effector (110) and distal shaft portion (160) that maybe readily incorporated into ultrasonic surgical instrument (10) (seeFIG. 1) in replacement of end effector (16) and distal shaft portion(62) described above, respectively. As will be described in greaterdetail below, distal shaft portion (160) includes a clamp arm closureassembly (162) that is configured to translate in order to drive a clamparm (112) of end effector (110) between an open position and closedposition when clamp arm (112) is in various clocked positions.Additionally, as will be described in greater detail below, clamp armclosure assembly (162) remains operatively engaged with clamp arm (112)without having to follow clamp arm (112) into the various clockedpositions.

A. Exemplary End Effector

End effector (110) includes clamp arm (112), clamp pad (115), a rotatingbody (120), and ultrasonic blade (130). Clamp arm (112), clamp pad(115), and ultrasonic blade (130) are substantially similar to clamp arm(44), clamp pad (48), and ultrasonic blade (46) described above,respectively, with differences elaborated below. Therefore, ultrasonicblade (130) is positioned at a distal end of an acoustic drivetrain.This acoustic drivetrain includes transducer assembly (54) (see FIG. 5)and acoustic waveguide (56), which includes flexible portion (58) (seeFIG. 3A).

Clamp arm (112) is pivotally coupled to distally projecting tongue (122)of rotating body (120) via pin (140) and pin holes (114, 124).Therefore, clamp arm (112) may pivot about pin (140) relative toultrasonic blade (130) between an open position (see FIGS. 17A-17B) anda closed position (see FIG. 17C). In the current example, pin (140) ishoused within pin holes (114, 124) such that pin (140) does not moverelative to pin holes (114, 124). However, pin (140) does notnecessarily have to be fixed within pin hole (114, 124). Pin (140) maybe a “floating pin” that may move within pin holes (114, 124) as clamparm (112) pivots between the open position and the closed position.Additionally, or alternatively, clamp arm (112) may be pivotablerelative to multiple axis/pins. Pin (140) may be coupled to rotatingbody (120) and clamp arm (112) through any suitable means as would beapparent to one skilled in the art in view of the teachings herein.

Clamp arm (112) also includes a pair of arms (116) that may besubstantially similar to arms (51) described above, with differenceselaborated below. Arms (116) include a respective inwardly presentedprotrusion (118) facing toward opposing arms (116). As best seen in FIG.7, inwardly presented protrusions (118) are housed within an annularexterior channel (168) defined by a translating body (164) of clamp armclosure assembly (162). As will be described in greater detail below,actuation of translating body (164) along a path defined by axis (132)is configured to pivot clamp arm (112) between the open position and theclosed position due to the interaction between inwardly presentedprotrusions (118) and annular exterior channel (168).

With respect to FIGS. 7-8, rotating body (120) includes distallypresented tongue (122) defining pin hole (124) and a gear including anannular array of proximally facing teeth (128). Rotating body (120) isrotatably disposed within casings (150). As mentioned above, distallypresented tongue (122) is configured to pivotably couple with clamp arm(112) via pin holes (114, 124) and pin (140). Therefore, as rotatingbody (120) rotates within casings (150) in accordance with thedescription herein, clamp arm (112) is rotated into various clockedpositions. As will be described in greater detail below, proximallyfacing teeth (128) are configured to suitably mesh with a compound gear(188) of clamp arm clocking assembly (180) such that clocking assembly(180) may drive rotation of rotating body (120) about axis (132)relative to blade (130) in order to rotate clamp arm (112) about axis(132) relative to blade (130). As will also be described in greaterdetail below, inwardly presented protrusions (118) are configured toactuate within annular exterior channel (168) defined by translatingbody (164) as clamp arm (112) rotates about axis (132) relative to blade(130).

Rotating body (120) defines a hollow opening (126) extending fromdistally presented tongue (122) to proximally facing teeth (128). Hollowopening (126) is dimensioned to receive a portion of ultrasonic blade(130), a portion of waveguide (56), and translating body (164) of distalshaft portion (160). As best shown in FIGS. 9 and 16, an interiorsurface of rotating body (120) defining hollow opening (126) alsodefines an annular slot (125). Annular slot (125) is dimensioned toreceive a waveguide pin (198) that extends through a distal portion ofwaveguide (56) and sleeve (196) of distal shaft portion (160).Therefore, rotating body (120) may be longitudinally fixed relative towaveguide (56) and blade (130), yet rotatable relative to waveguide (56)and blade (130) about axis (132). Pin (198) may extend through a nodalposition of waveguide (56) during exemplary use. It should be understoodthe distal portion of waveguide (56) is distal relative to flexibleportion (58) of waveguide (56).

B. Exemplary Distal Shaft Portion

As best seen in FIGS. 8-9, distal shaft portion (160) includes a pair ofcasings (150) that are configured to mate together in order to housevarious components of end effector (110) and distal shaft portion (160).A proximal end of each casing (150) is fixed to a distal end ofarticulation section (64). Therefore, as articulation section (64)articulates in accordance with the description above, distal shaftportion (160) and end effector (110) also deflects. Distal shaft portion(160) also includes sleeve (196), a clamp arm closure assembly (162),and a clamp arm clocking assembly (180). As mentioned above, sleeve(196) is coupled with waveguide (56) via waveguide pin (198). Therefore,sleeve (196) is configured to move with the associated portion ofwaveguide (56) as waveguide (56) rotates and articulates in accordancewith the description herein.

As will be described in greater detail below, clamp arm clockingassembly (180) is configured to rotate clamp arm (112) and clamp pad(115) of end effector (110) about axis (132) defined by ultrasonic blade(130) in order to position clamp arm (112) and clamp pad (115) atvarious clocking positions relative to both blade (130) and clamp armclosure assembly (162) of distal shaft portion (160).

As will also be described in greater detail below, a clamp arm closureassembly (162) of distal shaft portion (160) is configured to translatein order to pivot clamp arm (112) and clamp pad (115) relative toultrasonic blade (130) about an axis defined by pin (140) between anopen position and a closed position. Additionally, clamp arm closureassembly (162) is operatively coupled with clamp arm (112) such that asclamp arm clocking assembly (180) rotates clamp arm (112) relative toblade (130) about axis (132), clamp arm closure assembly (162) remainsoperatively engaged with clamp arm (112) as well as in a substantiallysimilar angular position relative to blade (130) about axis (132). Inother words, clamp arm closure assembly (162) is configured to (i)remain in a substantially fixed angular position about axis (132)relative to blade (130) as clamp arm (112) rotates into various clockedpositions, and (ii) pivot clamp arm (112) toward and away from blade(130), regardless of the clocked position of clamp arm (112). Allowingclamp arm closure assembly (162) to remain in the same rotationalposition about axis (132) relative to blade (130) while maintaining thefunctionality of pivoting clamp arm (112) about the axis defined by pin(140) may further simplify connections of clamp arm closure assembly(162) to various other parts of instrument (10) as well as provide for ahigher degree of precision in clamping (i.e. pivoting clamp arm (112)from the open position to the closed position).

Clamp arm clocking assembly (180) includes a translating driver (182), arack (184), and a compound gear (188). Translating driver (182) extendsproximally through shaft assembly (14) and is operatively connected toat least one linear system actuator (36 b, 36 c, 36 d, 36 e, 36 f) (seeFIG. 6). Therefore, linear system actuator (36 b, 36 c, 36 d, 36 e, 36f) (see FIG. 6) coupled with the proximal end of translating driver(182) may actuate translating driver (182) proximally and distallyrelative to the rest of distal shaft portion (160). A distal end oftranslating driver (182) is fixed to rack (184) such that proximal anddistal translation of translating driver (182) results in correspondingproximal and distal translation of rack (184). Rack (184) includes alinear array of teeth (186) that suitably mesh with teeth of a firstgear (192) of compound gear (188). Therefore, translation of rack (184)results in rotation of compound gear (188).

Compound gear (188) includes a pin (190), first gear (192), and a secondgear (194). Pin (190) extends along an axis through first gear (192) andsecond gear (194). Pin (190) is coupled with sleeve (196) via pin hole(197) such that suitable portions of compound gear (188) may rotateabout the axis defined by pin (190) relative to sleeve (196) whileinhibiting translation of compound gear (188) relative to sleeve (196).Pin (190) also extends through a longitudinal slot (172) defined bytranslating body (164). Longitudinal slot (172) is long enough toaccommodate for translation of translating body (164), in accordancewith the description herein, without unduly interfering with pin (190).

First gear (192) and second gear (194) are configured to rotate about anaxis defined by pin (190). First gear (192) and second gear (194) arecoupled with each other such that as first gear (192) rotates an angulardisplacement about the axis defined by pin (190), second gear (194) alsorotates the same angular displacement about the axis defined by pin(190). Second gear (194) has a larger diameter compared to first gear(192), such that teeth of second gear (194) travel a further distancecompared to teeth of first gear (192), even though both gears (192, 194)are rotated about pin (190) with the same angular displacement. Gears(192, 194) and pin (190) may be coupled with each other through anysuitable means as would be apparent to one skilled in the art in view ofthe teachings herein.

As mentioned above, first gear (192) suitably meshes with teeth (186) ofrack (184) such that proximal and distal translation of rack (184)rotates first gear (192) and second gear (194) about the axis defined bypin (190). As also mentioned above, rotating body (120) is rotatablydisposed within casings (150) such that rotating body (120) may rotateabout axis (132) defined by blade (130). Teeth of second gear (194)suitably mesh with proximally facing teeth (128) of rotating body (120)such that rotation of second gear (194) about the axis defined by pin(190) drives rotation of rotating body (120) about axis (132) defined byblade (130). Therefore, since clamp arm (112) is coupled to rotatingbody (120), translation of rack (184) in the proximal direction and thedistal direction is configured to rotate rotating body (120) and clamparm (112) about axis (132) defined by blade (130) in a first rotationaldirection and a second, opposite, rotational direction, respectively. Inother words, translation of translating driver (182) is configured tochange the clocked position of clamp arm (112) relative to blade (130).

Rack (184) and compound gear (188) are configured to rotate with sleeve(196) in accordance with the description herein. Therefore, whenwaveguide (56) rotates in the direction indicated by arrow (66) (seeFIG. 3A), rack (184) and compound gear (188) also rotate in thedirection indicated by arrow (66) (see FIG. 3A). Engagement betweensecond gear (194) and proximally facing teeth (128) may drive rotatingbody (120) and clamp arm (112) to also rotate with waveguide (56) in thedirection indicated by arrow (66) (see FIG. 3A). Therefore, whenwaveguide (56) is rotated in the direction indicated by arrow (66) (seeFIG. 3A), clamp arm (112) may remain in the same clocked positionrelative to blade (130).

While in the current example, rack (184), compound gear (188), andproximally facing teeth (128) are used to convert translation oftranslating driver (182) into rotation of clamp arm (112) about blade(130), any other suitable means may be used to rotate clamp arm (112)about blade (130) as would be apparent to one skilled in the art in viewof the teachings herein. Therefore, when a shaft assembly (14) rotatesin the direction indicated by arrow (66) (see FIG. 3A), distal shaftportion (160) and end effector (110) may also rotate in the directionindicated by arrow (66) (see FIG. 3A).

Clamp arm closure assembly (162) includes translating body (164) andtranslating drivers (174). Similar to translating driver (182) describedabove, translating drivers (174) extend proximally through shaftassembly (14) and are operatively connected to at least one linearsystem actuator (36 b, 36 c, 36 d, 36 e, 36 f) other than linear systemactuator (36 b, 36 c, 36 d, 36 e, 36 f) coupled to translating drivers(182). Therefore, linear system actuator (36 b, 36 c, 36 d, 36 e, 36 f)coupled with the proximal end of translating drivers (174) may actuatetranslating drivers (174) proximally and distally relative to the restof distal shaft portion (160) independently of translating driver (182).Distal ends of translating drivers (174) are fixed to translating body(164) such that proximal and distal translation of translating drivers(174) results in corresponding proximal and distal translation oftranslating body (164).

Translating body (164) defines a hollow opening (166), annular exteriorchannel (168), a first longitudinal slot (170), and second longitudinalslot (172). Hollow opening (166) extends from a proximal end to a distalend of translating body (164). Hollow opening (166) is dimensioned toslidably receive sleeve (196) such that translating body (164) mayactuate relative to sleeve (196) and blade (130).

First longitudinal slot (170) is dimensioned to house waveguide pin(198) such that translating body (164) may translate relative to sleeve(196) and blade (130), but such that translating body (164) isrotationally fixed relative to sleeve (196) and blade (130). In otherwords, as waveguide (56) and blade (130) are rotated in the directionindicated by arrow (66) (see FIG. 3A) in accordance with the descriptionherein, waveguide pin (198) drives corresponding rotation of sleeve(196) and translating body (164). Annular exterior channel (168)operatively houses inwardly presented protrusions (118) such thattranslation of body (164) drives clamp arm (112) to pivot about pin(140). Therefore, translating body (164) may be driven proximally anddistally via translating drivers (174) in order to pivot clamp arm (112)about pin (140) toward and away from blade (130).

Additionally, annular exterior channel (168) is configured tooperatively house inwardly presented protrusions (118) as clamp arm(112) is clocked in various positions about axis (132) in accordancewith the description herein. Therefore, annular exterior channel (168)acts as a track to retain inwardly presented protrusions (118). Becauseannular exterior channel (168) can operatively house inwardly presentedprotrusion (118) as clamp arm (112) is clocked in various positionsrelative to blade (130) about axis (132), translating body (164) mayretain the ability to pivot clamp arm (112) in a plurality of clockedpositions without having to rotate with clamp arm (112) about axis(132). Allowing translating body (164) to retain the ability to pivotclamp arm (112) in a plurality of clocked positions without having torotate with clamp arm (112) about axis (132) may provide for a higherdegree of precision for pivoting clamp arm (112) about pin (140).

In the current example, annular exterior channel (168) extends all theway around a circumferential portion of translating body (164) such thatannular exterior channel (168) is continuous, however this is merelyoptional. Annular exterior channel (168) may extend circumferentiallyaround only a portion of translating body (164) in order to accommodatethe various intended clocking position of clamp arm (112). For instance,in some embodiments, annular exterior channel (168) may extendcircumferentially around a portion of translating body (164) such thatterminating ends of annular exterior channel (168) are 180 degreesapart.

FIGS. 17A-17C show an exemplary use of clamp arm clocking assembly (180)and clamp arm closure assembly (162) being used in order to rotate clamparm (112) about blade (130) (See FIGS. 17A-17B), and then pivot clamparm (112) about pin (140) in order to drive clamp arm (112) from theopen position to the closed position (See FIGS. 17B-17C). FIG. 17A showsclamp arm (112) in the open position and a first clocked positionrelative to blade (130). If the operator desires to change the clockedposition of clamp arm (112), the operator may instruct instrument (10′)to drive translating driver (182) proximally, which in turn rotatesrotating body (120) and clamp arm (112) about blade (130) into a secondclocked position.

It should be understood that as clamp arm (112) is rotated about blade(130) into the second clocked position, inwardly presented protrusions(118) are still operatively housed within annular exterior channel (168)of translating body (164). It should also be understood that translatingbody (164) remains in the same angular position about axis (132) ofblade (130) as clamp arm (112) is rotated into the second clockedposition. If the operator desires to rotate clamp arm (112) back towardthe first clocked position, the operator may instruct instrument (10′)to drive translating driver (182) distally until clamp arm (112) isdriven into the desired clocked position.

Next, with clamp arm (112) rotated about blade (130) into the desiredclocked position, the operator may instruct instrument (10′) to drivetranslating drivers (174) and translating body (164) proximally, whichin turn pivots clamp arm (112) to the closed position. It should beunderstood that since inwardly presented protrusions (118) areoperatively housed within annular exterior channel (168) while clamp arm(112) is in any clocked position, proximal translation of translatingbody (164) drives protrusions (118) proximally, which in turn pivotsclamp arm (112) about pin (140) into the closed position. If theoperator desires to pivot clamp arm (112) back toward the open position,the operator may instruct instrument (10′) to drive translating drivers(174) distally until clamp arm (112) is pivoted about pin (140) into thedesired position.

It should be understood that the operator may rotate clamp arm (112) tothe second locked position while clamp arm (112) is in the closedposition as well. In the current example, clamp arm (112) is rotatedabout blade (130) 180 degrees from the first clocked position. Clamp arm(112) may be rotated about blade (130) to any other suitably clockedposition as would be apparent to one skilled in the art in view of theteachings herein. In the current example, rack (184) extends along alength to rotate clamp arm (112) a maximum of 180 degrees about blade(130). It should be understood that rack (184) may have any suitablelength to rotate clamp arm (112) about blade (130) at any suitableangular displacement as would be apparent to one skilled in the art inview of the teachings herein. For instance, rack (184) may have asuitable length to rotate clamp arm (112) 360 degrees about blade (130).

III. Exemplary Combinations

The following examples relate to various non-exhaustive ways in whichthe teachings herein may be combined or applied. It should be understoodthat the following examples are not intended to restrict the coverage ofany claims that may be presented at any time in this application or insubsequent filings of this application. No disclaimer is intended. Thefollowing examples are being provided for nothing more than merelyillustrative purposes. It is contemplated that the various teachingsherein may be arranged and applied in numerous other ways. It is alsocontemplated that some variations may omit certain features referred toin the below examples. Therefore, none of the aspects or featuresreferred to below should be deemed critical unless otherwise explicitlyindicated as such at a later date by the inventors or by a successor ininterest to the inventors. If any claims are presented in thisapplication or in subsequent filings related to this application thatinclude additional features beyond those referred to below, thoseadditional features shall not be presumed to have been added for anyreason relating to patentability.

Example 1

A surgical instrument, comprising: (a) an end effector, comprising: (i)an ultrasonic blade, (ii) a rotating body configured to rotate relativeto the ultrasonic blade, and (iii) a clamp arm movably coupled to therotating body, wherein the clamp arm is configured to move relative tothe rotating body and the ultrasonic blade between an open position anda closed position; and (b) a shaft assembly extending along an axis, theshaft assembly comprising: (i) a clamp arm clocking assembly configuredto drive rotation of the rotating body and the clamp arm about the axisrelative to the ultrasonic blade between a first clocked position and asecond clocked position, and (ii) a clamp arm pivot assembly comprisingan actuator body located in a first rotational position relative to theultrasonic blade about the axis, wherein the actuator body is configuredto actuate between a distal position and a proximal position in order todrive the clamp arm between the open position and the closed position,wherein the actuator body defines a track housing a portion of the clamparm, wherein the track is configured to house the portion of the clamparm when the clamp arm is in the first clocked position and the secondclocked position while the actuator body is located in the firstrotational position.

Example 2

The surgical instrument of Example 1, wherein the portion of the clamparm housed within the track comprises a first protrusion and a secondprotrusion.

Example 3

The surgical instrument of Example 2, wherein the clamp arm comprises afirst arm and a second arm, wherein the first protrusion is attached tothe first arm, wherein the second protrusion is attached to the secondarm.

Example 4

The surgical instrument of Example 3, wherein the first protrusion andthe second protrusion face toward each other.

Example 5

The surgical instrument of any one or more of Examples 1 through 4,wherein the track comprises an annular channel.

Example 6

The surgical instrument of Example 5, wherein the annular channel iscontinuous.

Example 7

The surgical instrument of Example 5, wherein the annular channel islocated on an exterior surface of the actuator body.

Example 8

The surgical instrument of any one or more of Examples 1 through 7,wherein the actuator body comprises a tubular body.

Example 9

The surgical instrument of any one or more of Examples 1 through 8,further comprising a waveguide in acoustic communication with theultrasonic blade, wherein a pin extends through the waveguide.

Example 10

The surgical instrument of Example 9, wherein the actuating body definesa first longitudinal slot, wherein the pin extends into the longitudinalslot, wherein the pin is configured to fix the actuating body in thefirst rotational position.

Example 11

The surgical instrument of Example 10, wherein the rotating body definesan annular slot, wherein the pin is housed within the annular slot.

Example 12

The surgical instrument of any one or more of Examples 1 through 11,wherein the rotating body comprises a distally presented tongue, whereinthe clamp arm is pivotably coupled with the distally presented tongue.

Example 13

The surgical instrument of Example 12, wherein the clamp arm ispivotably coupled with the distally presented tongue via a pivot pin.

Example 14

The surgical instrument of any one or more of Examples 1 through 13,wherein the clamp arm clocking assembly comprises a rack and a compoundgear, wherein the rack is configured to translate in order to rotate thecompound gear.

Example 15

The surgical instrument of Example 14, wherein the compound gear isoperatively coupled with the rotating body, wherein the compound gear isconfigured to rotate the rotating body.

Example 16

A surgical instrument, comprising: (a) an end effector, comprising: (i)an ultrasonic blade, (ii) a rotating body disposed around a portion ofthe ultrasonic blade, wherein the rotating body is configured to rotatearound the portion of the ultrasonic blade, and (iii) a clamp armpivotably coupled to the rotating body, wherein the clamp arm isconfigured to pivot relative to the rotating body and the ultrasonicblade between an open position and a closed position, wherein the clamparm is configured to rotate around the ultrasonic blade between a firstclocked position and a second clocked position; (b) an actuator bodyconfigured to translate relative to the ultrasonic blade while locatedin a first rotational position relative to the ultrasonic blade, whereinthe actuator body defines a track housing a portion of the clamp arm,wherein the actuator body is configured to actuate the portion of theclamp arm in order to drive the clamp arm between the open position andthe closed position, wherein the track is configured to house theportion of the clamp arm when the clamp arm is in the first clockedposition and the second clocked position while the actuator body islocated in the first rotational position.

Example 17

The surgical instrument of Example 16, wherein the actuator body isdisposed around a portion of the ultrasonic blade.

Example 18

The surgical instrument of any one or more of Examples 16 through 17,wherein the track extends along an exterior portion of the actuatorbody.

Example 19

The surgical instrument of any one or more of Examples 16 through 18,further comprising a translating driver attached to the actuator body,wherein the translating driver is configured to actuate the actuatorbody relative to the ultrasonic blade.

Example 20

A surgical instrument, comprising: (a) an end effector, comprising: (i)an ultrasonic blade extending along an axis, (ii) a clamp arm configuredto pivot relative to the ultrasonic blade between an open position and aclosed position, wherein the clamp arm is configured to rotate aroundthe axis relative to the ultrasonic blade between a first clockedposition and a second clocked position; (b) an actuator body configuredto translate relative to the ultrasonic blade while located in a firstrotational position relative to the ultrasonic blade, wherein theactuator body defines a track housing a portion of the clamp arm,wherein the actuator body is configured to actuate the portion of theclamp arm in order to drive the clamp arm between the open position andthe closed position, wherein the track is configured to house theportion of the clamp arm when the clamp arm is in the first clockedposition and the second clocked position while the actuator body islocated in the first rotational position.

IV. Miscellaneous

Any one or more of the teaching, expressions, embodiments, examples,etc. described herein may be combined with any one or more of theteachings, expressions, embodiments, examples, etc. described in U.S.patent application Ser. No. 16/556,661entitled “Ultrasonic SurgicalInstrument with a Multi-Planar Articulating Shaft Assembly,” filed onAug. 30, 2019, published as U.S. Pub. No. 2021/0059709 on Mar. 4, 2021;U.S. patent application Ser. No. 16/556,667, entitled “UltrasonicTransducer Alignment of an Articulating Ultrasonic Surgical Instrument,”filed on Aug. 30, 2019, published as U.S. Pub. No. 2021/0059710 on Mar.4, 2021; U.S. patent application Ser. No. 16/556,635, entitled“Ultrasonic Blade and Clamp Arm Alignment Features,” filed on Aug. 30,2019, published as U.S. Pub. No. 2021/0059708 on Mar. 4, 2021; and/orU.S. patent application Ser. No. 16/556,727, entitled “Rotatable LinearActuation Mechanism,” filed on Aug. 30, 2019, published as U.S. Pub. No.2021/0059711 on Mar. 4, 2021. The disclosure of each of theseapplications is incorporated by reference herein.

It should be understood that any of the versions of instrumentsdescribed herein may include various other features in addition to or inlieu of those described above. By way of example only, in addition tothe teachings above, it should be understood that the instrumentsdescribed herein may be constructed and operable in accordance with atleast some of the teachings of U.S. Pat. Nos. 5,322,055; 5,873,873;5,980,510; 6,325,811; 6,773,444; 6,783,524; 9,095,367; U.S. Pub. No.2006/0079874, now abandoned; U.S. Pub. No. 2007/0191713, now abandoned;U.S. Pub. No. 2007/0282333, now abandoned; U.S. Pub. No. 2008/0200940,now abandoned; U.S. Pat. No. 8,623,027, issued Jan. 7, 2014; U.S. Pat.No. 9,023,071, issued May 5, 2015; U.S. Pat. No. 8,461,744, issued Jun.11, 2013; U.S. Pat. No. 9,381,058, issued Jul. 5, 2016; U.S. Pub. No.2012/0116265, now abandoned; U.S. Pat. No. 9,393,037, issued Jul. 19,2016; U.S. Pat. No. 10,172,636, issued Jan. 8, 2019; and/or U.S. Pat.App. No. 61/410,603. The disclosures of each of the foregoing patents,publications, and applications are incorporated by reference herein. Itshould also be understood that the instruments described herein may havevarious structural and functional similarities with the HARMONIC ACE®Ultrasonic Shears, the HARMONIC WAVE® Ultrasonic Shears, the HARMONICFOCUS® Ultrasonic Shears, and/or the HARMONIC SYNERGY® UltrasonicBlades. Furthermore, the instruments described herein may have variousstructural and functional similarities with the devices taught in any ofthe other references that are cited and incorporated by referenceherein.

To the extent that there is some degree of overlap between the teachingsof the references cited herein, the HARMONIC ACE® Ultrasonic Shears, theHARMONIC WAVE® Ultrasonic Shears, the HARMONIC FOCUS® Ultrasonic Shears,and/or the HARMONIC SYNERGY® Ultrasonic Blades, and the teachings hereinrelating to the instruments described herein, there is no intent for anyof the description herein to be presumed as admitted prior art. Severalteachings herein will in fact go beyond the scope of the teachings ofthe references cited herein and the HARMONIC ACE® Ultrasonic Shears, theHARMONIC WAVE® Ultrasonic Shears, the HARMONIC FOCUS® Ultrasonic Shears,and the HARMONIC SYNERGY® Ultrasonic Blades.

It should be appreciated that any patent, publication, or otherdisclosure material, in whole or in part, that is said to beincorporated by reference herein is incorporated herein only to theextent that the incorporated material does not conflict with existingdefinitions, statements, or other disclosure material set forth in thisdisclosure. As such, and to the extent necessary, the disclosure asexplicitly set forth herein supersedes any conflicting materialincorporated herein by reference. Any material, or portion thereof, thatis said to be incorporated by reference herein, but which conflicts withexisting definitions, statements, or other disclosure material set forthherein will only be incorporated to the extent that no conflict arisesbetween that incorporated material and the existing disclosure material.

Versions of the devices described above may have application inconventional medical treatments and procedures conducted by a medicalprofessional, as well as application in robotic-assisted medicaltreatments and procedures. By way of example only, various teachingsherein may be readily incorporated into another example of a roboticsurgical system, and those of ordinary skill in the art will recognizethat various teachings herein may be readily combined with variousteachings of any of the following: U.S. Pat. No. 8,844,789, entitled“Automated End Effector Component Reloading System for Use with aRobotic System,” issued Sep. 30, 2014, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 8,820,605, entitled“Robotically-Controlled Surgical Instruments,” issued Sep. 2, 2014, thedisclosure of which is incorporated by reference herein; U.S. Pat. No.8,616,431, entitled “Shiftable Drive Interface forRobotically-Controlled Surgical Tool,” issued Dec. 31, 2013, thedisclosure of which is incorporated by reference herein; U.S. Pat. No.8,573,461, entitled “Surgical Stapling Instruments with Cam-DrivenStaple Deployment Arrangements,” issued Nov. 5, 2013, the disclosure ofwhich is incorporated by reference herein; U.S. Pat. No. 8,602,288,entitled “Robotically-Controlled Motorized Surgical End Effector Systemwith Rotary Actuated Closure Systems Having Variable Actuation Speeds,”issued Dec. 10, 2013, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 9,301,759, entitled“Robotically-Controlled Surgical Instrument with SelectivelyArticulatable End Effector,” issued Apr. 5, 2016, the disclosure ofwhich is incorporated by reference herein; U.S. Pat. No. 8,783,541,entitled “Robotically-Controlled Surgical End Effector System,” issuedJul. 22, 2014, the disclosure of which is incorporated by referenceherein; U.S. Pat. No. 8,479,969, entitled “Drive Interface for OperablyCoupling a Manipulatable Surgical Tool to a Robot,” issued Jul. 9, 2013;U.S. Pat. No. 8,800,838, entitled “Robotically-Controlled Cable-BasedSurgical End Effectors,” issued Aug. 12, 2014, the disclosure of whichis incorporated by reference herein; and/or U.S. Pat. No. 8,573,465,entitled “Robotically-Controlled Surgical End Effector System withRotary Actuated Closure Systems,” issued Nov. 5, 2013, the disclosure ofwhich is incorporated by reference herein.

Versions described above may be designed to be disposed of after asingle use, or they can be designed to be used multiple times. Versionsmay, in either or both cases, be reconditioned for reuse after at leastone use. Reconditioning may include any combination of the steps ofdisassembly of the device, followed by cleaning or replacement ofparticular pieces, and subsequent reassembly. In particular, someversions of the device may be disassembled, and any number of theparticular pieces or parts of the device may be selectively replaced orremoved in any combination. Upon cleaning and/or replacement ofparticular parts, some versions of the device may be reassembled forsubsequent use either at a reconditioning facility, or by an operatorimmediately prior to a procedure. Those skilled in the art willappreciate that reconditioning of a device may utilize a variety oftechniques for disassembly, cleaning/replacement, and reassembly. Use ofsuch techniques, and the resulting reconditioned device, are all withinthe scope of the present application.

By way of example only, versions described herein may be sterilizedbefore and/or after a procedure. In one sterilization technique, thedevice is placed in a closed and sealed container, such as a plastic orTYVEK bag. The container and device may then be placed in a field ofradiation that can penetrate the container, such as gamma radiation,x-rays, or high-energy electrons. The radiation may kill bacteria on thedevice and in the container. The sterilized device may then be stored inthe sterile container for later use. A device may also be sterilizedusing any other technique known in the art, including but not limited tobeta or gamma radiation, ethylene oxide, or steam.

Having shown and described various embodiments of the present invention,further adaptations of the methods and systems described herein may beaccomplished by appropriate modifications by one of ordinary skill inthe art without departing from the scope of the present invention.Several of such potential modifications have been mentioned, and otherswill be apparent to those skilled in the art. For instance, theexamples, embodiments, geometrics, materials, dimensions, ratios, steps,and the like discussed above are illustrative and are not required.Accordingly, the scope of the present invention should be considered interms of the following claims and is understood not to be limited to thedetails of structure and operation shown and described in thespecification and drawings.

We claim:
 1. A surgical instrument, comprising: (a) an end effector,comprising: (i) an ultrasonic blade, (ii) a rotating body configured torotate relative to the ultrasonic blade, and (iii) a clamp arm movablycoupled to the rotating body, wherein the clamp arm is configured tomove relative to the rotating body and the ultrasonic blade between anopen position and a closed position; (b) a waveguide in acousticcommunication with the ultrasonic blade, wherein a pin extends throughthe waveguide; and (c) a shaft assembly extending along an axis, theshaft assembly comprising: (i) a clamp arm clocking assembly configuredto drive rotation of the rotating body and the clamp arm about the axisrelative to the ultrasonic blade between a first clocked position and asecond clocked position, and (ii) a clamp arm pivot assembly comprisingan actuator body located in a first rotational position relative to theultrasonic blade about the axis, wherein the actuator body is configuredto actuate between a distal position and a proximal position in order todrive the clamp arm between the open position and the closed position,wherein the actuator body defines a track housing a portion of the clamparm, wherein the track is configured to house the portion of the clamparm when the clamp arm is in the first clocked position and the secondclocked position while the actuator body is located in the firstrotational position.
 2. The surgical instrument of claim 1, wherein theportion of the clamp arm housed within the track comprises a firstprotrusion and a second protrusion.
 3. The surgical instrument of claim2, wherein the clamp arm comprises a first arm and a second arm, whereinthe first protrusion is attached to the first arm, wherein the secondprotrusion is attached to the second arm.
 4. The surgical instrument ofclaim 3, wherein the first protrusion and the second protrusion facetoward each other.
 5. The surgical instrument of claim 1, wherein thetrack comprises an annular channel.
 6. The surgical instrument of claim5, wherein the annular channel is continuous.
 7. The surgical instrumentof claim 5, wherein the annular channel is located on an exteriorsurface of the actuator body.
 8. The surgical instrument of claim 1,wherein the actuator body comprises a tubular body.
 9. The surgicalinstrument of claim 1, wherein the actuating body defines a firstlongitudinal slot, wherein the pin extends into the longitudinal slot,wherein the pin is configured to fix the actuating body in the firstrotational position.
 10. The surgical instrument of claim 9, wherein therotating body defines an annular slot, wherein the pin is housed withinthe annular slot.
 11. The surgical instrument of claim 1, wherein therotating body comprises a distally presented tongue, wherein the clamparm is pivotably coupled with the distally presented tongue.
 12. Thesurgical instrument of claim 11, wherein the clamp arm is pivotablycoupled with the distally presented tongue via a pivot pin.
 13. Thesurgical instrument of claim 1, wherein the clamp arm clocking assemblycomprises a rack and a compound gear, wherein the rack is configured totranslate in order to rotate the compound gear.
 14. The surgicalinstrument of claim 13, wherein the compound gear is operatively coupledwith the rotating body, wherein the compound gear is configured torotate the rotating body.
 15. A surgical instrument, comprising: (a) anend effector, comprising: (i) an ultrasonic blade, (ii) a rotating bodydisposed around a portion of the ultrasonic blade, wherein the rotatingbody is configured to rotate around the portion of the ultrasonic blade,and (iii) a clamp arm pivotably coupled to the rotating body, whereinthe clamp arm is configured to pivot relative to the rotating body andthe ultrasonic blade between an open position and a closed position,wherein the clamp arm is configured to rotate around the ultrasonicblade between a first clocked position and a second clocked position;(b) an actuator body configured to translate relative to the ultrasonicblade while located in a first rotational position relative to theultrasonic blade; (c) a clamp arm clocking assembly configured to driverotation of the rotating body and the clamp arm around the ultrasonicblade between the first clocked position and the second clockedposition, wherein the clamp arm clocking assembly comprises: (i) a rack,and (ii) a compound gear, wherein the rack is configured to translate inorder to rotate the compound gear.
 16. The surgical instrument of claim15, wherein the actuator body is disposed around a portion of theultrasonic blade.
 17. The surgical instrument of claim 15, where theactuator body defines a track housing a portion of the clamp arm,wherein the track extends along an exterior portion of the actuatorbody.
 18. The surgical instrument of claim 15, further comprising atranslating driver attached to the actuator body, wherein thetranslating driver is configured to actuate the actuator body relativeto the ultrasonic blade.
 19. A surgical instrument, comprising: (a) anend effector, comprising: (i) an ultrasonic blade extending along anaxis, (ii) a clamp arm configured to pivot relative to the ultrasonicblade between an open position and a closed position, wherein the clamparm is configured to rotate around the axis relative to the ultrasonicblade between a first clocked position and a second clocked position;(b) an actuator body configured to translate relative to the ultrasonicblade while located in a first rotational position relative to theultrasonic blade; and (c) a clamp arm clocking assembly configured todrive rotation of the clamp arm around the axis relative to theultrasonic blade, wherein the clamp arm clocking assembly comprises: (i)a translating input body, (ii) a rotating output body operativelyconnected to the clamp arm, wherein rotation of the rotating output bodyis configured to rotate the clamp arm around the axis relative to theultrasonic blade, and (iii) a compound gear interposed between thetranslating input body and the rotating output body, wherein thetranslating input body is configured to translate to drive rotation ofthe compound gear, wherein the compound gear is configured to rotate todrive rotation of the rotating output body.